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Reply to comment on Li et al.: Non-continuous versus continuous wound drainage after total knee arthroplasty: a meta-analysis.对关于李等人研究的评论的回复:全膝关节置换术后非连续性与连续性伤口引流:一项荟萃分析
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Repeat-dose intravenous tranexamic acid further decreases blood loss in total knee arthroplasty.重复静脉注射氨甲环酸可进一步减少全膝关节置换术的失血。
Int Orthop. 2013 Mar;37(3):441-5. doi: 10.1007/s00264-013-1787-7. Epub 2013 Feb 1.
2
No difference in total blood loss, haemoglobin and haematocrit between continues and intermittent wound drainage after total knee arthroplasty.全膝关节置换术后持续与间断伤口引流对总失血量、血红蛋白和血细胞比容无差异。
Knee Surg Sports Traumatol Arthrosc. 2013 Dec;21(12):2831-6. doi: 10.1007/s00167-012-2253-6. Epub 2012 Oct 23.
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Temporary clamping of drain combined with tranexamic acid reduce blood loss after total knee arthroplasty: a prospective randomized controlled trial.引流管临时夹闭联合氨甲环酸减少全膝关节置换术后失血:一项前瞻性随机对照试验。
BMC Musculoskelet Disord. 2012 Jul 20;13:124. doi: 10.1186/1471-2474-13-124.
4
Three-hour interval drain clamping reduces postoperative bleeding in total knee arthroplasty: a prospective randomized controlled trial.三小时间隔夹管减少全膝关节置换术后出血:一项前瞻性随机对照试验。
Arch Orthop Trauma Surg. 2012 Jul;132(7):1059-63. doi: 10.1007/s00402-012-1501-z. Epub 2012 Mar 13.
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Postoperative blood loss reduction in computer-assisted surgery total knee replacement by low dose intra-articular tranexamic acid injection together with 2-hour clamp drain: a prospective triple-blinded randomized controlled trial.低剂量关节腔内注射氨甲环酸联合2小时夹闭引流用于计算机辅助手术全膝关节置换术减少术后失血:一项前瞻性三盲随机对照试验
Orthop Rev (Pavia). 2011;3(2):e12. doi: 10.4081/or.2011.e12. Epub 2011 Jun 29.
6
The comparison of the effects of intraoperative bleeding control and postoperative drain clamping methods on the postoperative blood loss and the need for transfusion following total knee arthroplasty.全膝关节置换术中出血控制及术后引流管夹闭方法对术后失血量及输血需求的影响比较
Acta Orthop Traumatol Turc. 2011;45(3):190-4. doi: 10.3944/AOTT.2011.2398.
7
Comparison of drain clamp after bilateral total knee arthroplasty.双侧全膝关节置换术后引流夹的比较
J Knee Surg. 2010 Dec;23(4):215-21. doi: 10.1055/s-0031-1271891.
8
Intra-articular injection of tranexamic acid reduces not only blood loss but also knee joint swelling after total knee arthroplasty.关节内注射氨甲环酸不仅可以减少全膝关节置换术后的出血量,还可以减轻膝关节肿胀。
Int Orthop. 2011 Nov;35(11):1639-45. doi: 10.1007/s00264-010-1205-3. Epub 2011 Jan 21.
9
Temporary drainage clamping after total knee arthroplasty: a meta-analysis of randomized controlled trials.全膝关节置换术后临时夹闭引流:一项随机对照试验的荟萃分析。
J Arthroplasty. 2010 Dec;25(8):1240-5. doi: 10.1016/j.arth.2009.08.013. Epub 2009 Oct 17.
10
Conventional drainage versus four hour clamping drainage after total knee arthroplasty in severe osteoarthritis: a prospective, randomised trial.重度骨关节炎全膝关节置换术后传统引流与四小时夹闭引流的前瞻性随机试验
Int Orthop. 2009 Oct;33(5):1275-8. doi: 10.1007/s00264-008-0662-4. Epub 2008 Oct 17.

全膝关节置换术后间断与持续引流的比较:一项荟萃分析。

Non-continuous versus continuous wound drainage after total knee arthroplasty: a meta-analysis.

机构信息

Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 100730, Beijing, People's Republic of China.

出版信息

Int Orthop. 2014 Feb;38(2):361-71. doi: 10.1007/s00264-013-2105-0. Epub 2013 Sep 19.

DOI:10.1007/s00264-013-2105-0
PMID:24048445
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3923945/
Abstract

PURPOSE

So far, controversy still exists regarding the use of non-continuous or continuous wound drainage after total knee arthroplasty. The aim of this study was to assess the efficacy and safety of these two drainage techniques after total knee arthroplasty.

METHODS

We searched the established electronic literature databases of Pubmed, Embase, Cochrane Library, CNKI, VIP and WANFANG. Nine RCTs including a total of 761 patients involving 811 knees were eligible for this meta-analysis.

RESULTS

Our results showed that non-continuous drainage was associated with less haemoglobin loss (WMD,  -0.43, 95 % CI -0.62 to -0.24; P < 0.00001) and postoperative visible blood loss (WMD,  -305.09, 95% CI -408.10 to -202.08; P < 0.00001) compared with continuous drainage. No significant difference was found between the two groups in terms of range of motion (WMD, 0.99, 95% CI -1.01 to 2.98; P = 0.33), incidence of blood transfusion (OR, 0.63, 95% CI 0.38 to 1.06; P = 0.80) or postoperative complications (OR, 1.09, 95% CI 0.35 to 3.40; P = 0.89).

CONCLUSION

The existing evidence indicates that non-continuous drainage can achieve less haemoglobin loss (especially the four- to six-hour drain clamping) and postoperative visible blood loss with no increased risk of postoperative complications compared with continuous drainage.

摘要

目的

迄今为止,全膝关节置换术后使用非连续或连续伤口引流仍存在争议。本研究旨在评估这两种引流技术在全膝关节置换术后的疗效和安全性。

方法

我们检索了 Pubmed、Embase、Cochrane 图书馆、CNKI、VIP 和 WANFANG 等已建立的电子文献数据库。共有 9 项 RCT 符合纳入标准,共纳入 761 例患者(811 膝)。

结果

我们的结果表明,与连续引流相比,非连续引流可减少血红蛋白丢失(WMD,-0.43;95%CI,-0.62 至-0.24;P<0.00001)和术后可见失血量(WMD,-305.09;95%CI,-408.10 至-202.08;P<0.00001)。两组在关节活动度方面无显著差异(WMD,0.99;95%CI,-1.01 至 2.98;P=0.33)、输血发生率(OR,0.63;95%CI,0.38 至 1.06;P=0.80)或术后并发症发生率(OR,1.09;95%CI,0.35 至 3.40;P=0.89)。

结论

现有证据表明,与连续引流相比,非连续引流可减少血红蛋白丢失(尤其是在四至六小时夹管时)和术后可见失血量,且术后并发症风险无增加。